Norwood 6 at age 38 means the entire top of your head has lost its hair coverage, with the frontal and crown bald zones fully merged. Only the horseshoe band around the sides and back remains. While this is an advanced stage, your age of 38 means your donor area is likely still dense and healthy enough to support a meaningful restoration plan.
What Norwood 6 Looks Like at 38
At Norwood 6, the bald area extends from the frontal hairline straight through to the crown with no bridge of hair remaining. The remaining horseshoe band typically runs from temple to temple across the back of the head.
| Norwood 6 at 38 | Details |
|---|---|
| Frontal hairline | Absent |
| Mid-scalp | Bald |
| Crown | Fully bald, merged with frontal zone |
| Remaining hair | Horseshoe band (sides and back) |
| Grafts needed | 4,000 to 6,000 |
| Sessions recommended | 2 to 3 |
Donor Reality at 38
Norwood 6 places the highest demand on your donor area of any stage except Norwood 7. At 38, your donor density is still near its peak, but the math requires careful planning.
| Factor | Typical Values |
|---|---|
| Caucasian donor density | 170 to 230 FU/cm2 |
| Asian donor density | 140 to 200 FU/cm2 |
| African donor density | 120 to 180 FU/cm2 |
| Safe extraction limit | 45% of available follicles |
| Estimated lifetime budget | 6,000 to 8,000 grafts |
| Norwood 6 requirement | 4,000 to 6,000 grafts |
Using 4,000 to 6,000 of a possible 6,000 to 8,000 lifetime grafts means you must plan carefully. Your surgeon should perform a detailed donor density assessment before committing to a specific graft count.
Staged Surgical Approach
Session 1: Frontal Hairline (2,000 to 2,500 grafts)
The first session focuses on rebuilding the frontal hairline and upper forehead zone. This area has the highest cosmetic impact because it is what others see in face-to-face conversation.
- FUE technique: 7 to 10 days recovery
- Graft survival: 90 to 95%
- Results visible at 6 to 9 months, final results at 12 to 15 months
Session 2: Mid-Scalp Density (1,500 to 2,000 grafts)
Scheduled 8 to 12 months after session 1, this fills the zone between the new hairline and the crown.
Session 3 (Optional): Crown Coverage (1,000 to 1,500 grafts)
Only pursued if donor supply allows after the first two sessions. The crown is the lowest priority because it is the least visible zone in daily interactions.
Cost Overview
| Region | Cost Per Graft | Total (4,000 to 6,000 Grafts) |
|---|---|---|
| Turkey | $1 to $2 | $4,000 to $12,000 |
| USA | $4 to $6 | $16,000 to $36,000 |
| UK | $3 to $5 | $12,000 to $30,000 |
| Europe | $2.50 to $4.50 | $10,000 to $27,000 |
| India | $0.50 to $1.50 | $2,000 to $9,000 |
Non-Surgical and Complementary Options
Scalp Micropigmentation (SMP)
SMP is one of the strongest complements to transplant surgery at Norwood 6. It deposits tiny pigment dots that mimic the appearance of shaved hair follicles, creating the illusion of density in areas where transplant coverage is sparse.
- Works between transplanted grafts for a fuller look
- Standalone option for men who prefer a shaved or buzzed style
- Lasts 3 to 5 years before needing a touch-up
Medication Support
Finasteride (1mg daily) protects your horseshoe band from thinning, which would shrink the donor area available for future procedures. It halts further loss in 80 to 90% of men. Minoxidil 5% can support miniaturized hairs along the edges of the bald zone.
Hair Systems
For men who want immediate full coverage without surgery, a modern hair system (custom hairpiece) bonded to the scalp can provide a natural look. This is a maintenance-based option rather than a permanent solution.
Setting Realistic Goals
At Norwood 6, the goal is not to recreate the density of your 20s. It is to build a natural-looking hairline, add visible mid-scalp coverage, and create the overall impression of having hair. When well-executed, even partial coverage at Norwood 6 produces a dramatic change in appearance.
Your Action Plan
- Get an AI assessment to confirm your stage and map remaining density
- Start or continue finasteride to protect your donor area
- Consult surgeons experienced in Norwood 6+ cases
- Request a donor density assessment with a specific lifetime graft budget
- Discuss whether SMP should complement your surgical plan
- Set realistic zone-by-zone goals with your surgeon
For full context on all stages, read the complete Norwood scale guide. Evaluate your surgical readiness with our transplant candidacy assessment.
Get your free AI hairline assessment to confirm your Norwood stage and explore your options.
This article is for informational purposes only and does not constitute medical advice. Consult a board-certified dermatologist or hair restoration specialist before starting any treatment.
FAQ
Is Norwood 6 hair loss normal at 38?
Norwood 6 at 38 is less common than milder stages but not rare among men with aggressive androgenetic alopecia. At this stage, the frontal and crown bald areas have fully merged into one large zone of baldness across the top of the head. Only the horseshoe band of hair around the sides and back remains. Men who reach Norwood 6 by 38 typically started losing hair in their early 20s.
What treatments work best for Norwood 6 at age 38?
A multi-session hair transplant of 4,000 to 6,000 grafts is the most impactful restoration option. Finasteride 1mg daily protects remaining hair and should be used lifelong. SMP (scalp micropigmentation) can fill gaps between transplanted hairs for added density appearance. The treatment plan should prioritize the frontal hairline first, with crown coverage as a secondary goal depending on donor supply.
Should I get a hair transplant at age 38 with Norwood 6?
A transplant at 38 with Norwood 6 can produce meaningful improvement, but realistic expectations are essential. Full density is not achievable due to donor limits. The typical approach is 2 to 3 sessions prioritizing the frontal zone, which creates the strongest visual change. At 38, your donor area is still healthy enough to support a substantial procedure if managed carefully.